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Osteochondritis dissecans

Definition


Disease: Osteochondritis dissecans Osteochondritis dissecans
Category: Bones, joints, muscles diseases

Disease Definition:

Osteochondritis dissecans might develop when blood supplying the area at the end of the bone is cut off. The affected bone and its covering of cartilage might remain in place and cause no symptoms, or a fragment might gradually loosen, separate and result in pain. Even though osteochondritis dissecans could occur in joints such as the elbow, hip and ankle, but the most commonly affected joint is the knee. Symptomatic osteochondritis dissecans mostly affects older children, teenagers and young adults, specifically those active in sports.
In order to minimize the risk of long-term disability, early diagnosis and treatment is essential for osteochondritis dissecans. The chances of recovery and return to usual activities, for instance, participation in sports are good in the case of being treated promptly.
 

Work Group:


Symptoms, Causes

Symptoms:

The most common symptom of osteochondritis dissecans is pain. The pain might be triggered by physical activity, for instance, knee pain that occurs while walking up stairs, playing sports or climbing a hill.
Osteochondritis dissecans has the following signs and symptoms:

 

  • Limping
  • Stiffness after resting
  • Swelling and tenderness of the skin over the joint
  • Pain
  • Feeling that the joint is weakening or “giving way”
  • A “locking” of the joint; the joint “sticks” and doesn’t move through its full range of motion
  • A limited range of motion or decreased joint movement such as being unable to fully straighten the leg or arm.
     

Causes:

The exact cause of osteochondritis dissecans is still not known. Yet, some factors might be leading to the disorder, such as:

Injury or stress: 

Repetitive force, such as trauma or stress, to the affected joint is on top of the list, specifically if the affected person is very active. The overlying cartilage of a joint may be damaged over time in case a person experiences small, multiple episodes of minor unrecognized injury.

Restricted blood supply:

Yet another reason is an impaired blood supply to the bone, a condition called vascular insufficiency. A slight blockage of a small artery is the cause of the impaired supply which could gradually result in a condition called avascular necrosis in which the bone tissue breaks down or dies.

Genetic makeup: 

Osteochondritis may develop in people who are genetically predisposed to the disease. 

 

A high risk of osteochondritis dissecans is found in people who perform regular physical activity, specifically when it contains repetitive impact movement that put stress on the joints, like jumping. Young people between the ages of 10 and 20, particularly active ones involved in organized sports, such as jumping, cutting or pivoting, such as in tennis, wrestling, gymnastics and basketball tend to be most affected by symptomatic osteochondritis dissecans. Additionally, people involved in throwing sports, like baseball pitchers might also be vulnerable.

 

Osteochondritis dissecans is a seldom occurring disease but it’s becoming more commonly diagnosed, especially among young females, as they participate more in organized sports.
 

Complications

Complications:

Degenerative osteoarthritis will probably develop in the affected joint in case the patient doesn’t receive effective treatment for osteochondritis dissecans.
 

Treatments:

In addition to reducing the risk of osteoarthritis, treatment of osteochondritis dissecans aims at restoring the normal function of the affected joint and relieving pain. Yet, there isn’t any single treatment that is effective for each person.

 

CONSERVATIVE MEASURES:

The doctor will first recommend conservative measures that are mostly effective, such as:

Immobilizing the joint: 

In case the knee or ankle is affected, a hinged brace or crutches could be used.

Resting the joint:

The affected person should keep away from impact activities such as jumping and from cut-pivot activities in which they could put strain on their knee as they rotate the joint. The patient will be instructed to refrain from throwing in case the injury is due to a throwing sport.

Physical therapy: 

This therapy usually includes stretching and range-of-motion exercises, as well as strengthening exercises for the muscles supporting the affected joint.  Additionally, to help maintain cardiovascular fitness, the patient could perform low-impact aerobic conditioning such as stationary bicycle usage.

Avoiding competitive sports and intense physical activity: 

These activities might add a strain on the affected joint and result in pain. For most people, resting for at least six to eight weeks and limiting competitive activity helps ease signs and symptoms.

Using nonsteroidal anti-inflammatory medications: 

Including acetylsalicylic acid, ibuprofen and naproxen sodium.

 

In case problems persist for at least three months, the joint motion is blocked and other treatments haven’t helped, surgery may be an option; however, this condition usually improves with conservative measures.

 

Arthroscopy is a surgery that is minimally invasive. It starts when a thin scope is inserted into the joint space to visualize the area on a television monitor. Later on, the location of the damage is determined and the best form of surgical operation is decided.

 

Tiny surgical instruments are inserted into small incisions, and loose bone fragments might be reattached or removed. The cartilage fragments could be tightly secured with pins or screws while they are still attached to the bone. Surgery’s aim is restoring normal blood flow and improving joint function. In order to optimize strength, function and stability, physical therapy is necessary after surgery.

 

Even though people suffering from osteochondritis dissecans mostly don’t have any symptoms after appropriate treatment, but in order to help decrease the risk of recurrence, restrictions on daily activities might be recommended. For instance, when young athletes might be able to return to playing sports, they might be asked to limit their participation primarily to light workouts, and later on gradually work back into competition after completing sport-specific conditioning exercises.
 

Prognosis:

Not available

Expert's opinion

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